Abstract

Background/Objective:

Diagnostic specificity remains disappointingly low for ultrasound-based methodologies optimized to achieve near 100% sensitivity. Opto-acoustic (OA) imaging is a fusion of real time co-registered, interleaved laser optic and ultrasound imaging that shows fused functional findings (relative de-oxygenation of hemoglobin) and morphologic information (tumor angiogenesis) within and around breast masses using a hand-held duplex OA probe. We assess the improvement in sensitivities and specificities of nomograms (N) based on regression models to classify (CL) benign (B) vs. malignant (M) and to project probability of malignancy (POM) based on five feature-based metrics scored by 21 independent readers (IRs) and an expert reader. We examine OA feature separation and nomogram performance.

The study results indicate that OA findings can be independently and quickly mastered by practicing IRs to consistently differentiate masses. Nomograms offer further confidence to enhance decision making to differentiate. If confirmed in a larger series, OA findings might be useful in differentiation and thus sparing biopsies in addition to more customized surgeries.